Abstract

Background

Studies have shown that vein size is an important predictor of successful ultrasound-guided
vascular access. The objective of this study is to evaluate maneuvers designed to
increase basilic vein size, which could be used to facilitate ultrasound-guided peripheral
intravenous access (USGPIV) in the Emergency Department (ED) setting.

Methods

This was a prospective non-randomized trial. Healthy volunteers aged 18-65 were enrolled.
Basilic veins were identified and the cross-sectional area measured sonographically.
Following baseline measurement, the following maneuvers were performed: application
of a tourniquet, inflation of a blood pressure (BP) cuff, application of a tourniquet
with the arm lowered, and BP cuff inflation with the arm lowered. Following each maneuver
there was 30 s of recovery time, and a baseline measurement was repeated to ensure
that the vein had returned to baseline. Change in basilic vein size was modeled using
mixed model analysis with a Tukey correction for multiple comparisons to determine
if significant differences existed between different maneuvers.

Conclusions

The largest increase in basilic vein size was due to blood pressure cuff inflation.
BP cuff inflation resulted in a statistically significant increase in vein size compared
to tourniquet application, but this difference may not be clinically significant.